Spark Integrative Wellness, Pllc
NPI #1053121574 in Johnson City, Tennessee
Provider Information
- NPI Number
- 1053121574
- Entity Type
- Organization
- Organization Name
- Spark Integrative Wellness, Pllc
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- Jan 8, 2025
- Last Updated
- Jan 8, 2025
Practice Location
- Address
- 2700 S ROAN ST STE 300A
- City
- Johnson City
- State
- Tennessee
- ZIP Code
- 37601-7556
- Phone
- (423) 722-2422
Authorized Official
- Name
- JENNIFER JUDY, APRN
- Title
- PMHNP
- Phone
- (423) 491-9146
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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